Periodontitis
Introduction
This is the progression of the inflammation of gingival into the deep tissue affecting the periodontal membrane causing periodontal pockets, introduction of infection and destruction of periodontium. The damage of the periodontal membrane, periodontal ligaments and eventually alveolar bone leads to formation of pockets which eventually favours more pathogenic bacterial growth. As the destruction continues the teeth become loose and may eventually fall out.
Pathophysiology
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Signs and symptoms
• Reddened, swollen gingiva
• Easily bleeding gingival on gently probing
• Periodontal pocket
• Loose/mobile teeth
• Bad breath from the mouth
• Gingival recession
Diagnostic criteria
• Reddened, swollen gingiva
• Easily bleeding gingival on gently probing
• Periodontal pocket
• Loose/mobile teeth
• Bad breath from the mouth
• Gingival recession
Investigation
X-ray (orthopantomogram (OPG) to determine extent of bone loss
Treatment
Non-pharmacological
- • Instruct and guide the patients on proper oral hygiene for proper plaque control
• Plaque control should be undertaken by the dentists by scaling and root planning (this may need several visits as may be necessary)
• Advanced treatment is required– if refractory/resistant to treatment or patient has systemic diseases/ conditions.
Pharmacological
- Mouth wash: Do not swallow
• Hydrogen peroxide 3% 6 hourly for at least for 5 days
OR
• Chlorhexidine gluconate 0.2% 12 hourly at least for 5 days
OR
Use antibiotics only for refractory and severe cases as well as those with evidence of periodontal abscess formation:
• Metronidazole (PO) 400mg 8 hourly for 8 days
AND EITHER
• Amoxicillin (PO) 500 mg 8 hourly for 8 days
OR
• Doxycycline (PO) 100mg 12 hourly for 10 days
Note: Patients with systemic diseases/conditions such as diabetes mellitus, liver and renal diseases, HIV/AIDS, and those who are pregnant or heavy smokers of cigarette are generally at increased risk of periodontal diseases and their management may need referral to a periodontal specialist.
Prevention
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Updated on,
4 Novemba 2020, 06:06:18
References
1.STG